18 month blood work

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Whitey26

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Attached is my 18 month bloodwork.
Current protocol is .40 cyp 200 every 3.5 days. No hcg just started back post blood work 35 units day of test. .25 ana once a week. Feeling horrible high anxiety low energy. Low penile sensitivity any input would be greatly appreciated
 

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Defy Medical TRT clinic doctor
Ya your SHBG is on the lower end. Would definitely up the anastrozole to twice a week, at the least. I personally would also switch to an EOD injection protocol, but it’s understandable if you don’t want to inject more than twice per week.

Also, it seems like everyone that posts labs lately has low DHEA. Yours is very very low. And without a doubt is giving you a bunch of negative symptoms. So without addressing your low DHEA, I doubt you are ever going to feel optimal. So definitely work on getting your DHEA into an optimal range.
 
Attached is my 18 month bloodwork.
Current protocol is .40 cyp 200 every 3.5 days. No hcg just started back post blood work 35 units day of test. .25 ana once a week. Feeling horrible high anxiety low energy. Low penile sensitivity any input would be greatly appreciated
What treatment regimen are you on for your diabetes?
 
I also noticed that. A1c 6.1 fasting glucose 123, are you a type 2 diabetic?

And insulin crazy high. If this isn’t all the signs of diabetes, idk what is. Good thing is testosterone is one of the best things to treat diabetes. Then add in some metformin, lose some weight, clean up the diet, and lift weights 3-4 times per week and u should kick diabetes ass in no time
 
Not diabetic. Just came off a surgery and laid Up for 6 weeks. Gained some weight and no gym for me = increased insulin resistance. Was just concerned about the free test being so high
 
Not diabetic. Just came off a surgery and laid Up for 6 weeks. Gained some weight and no gym for me = increased insulin resistance. Was just concerned about the free test being so high

Oh ok that makes sense. Ya didn’t mean to scare ya with the diabetes talk lol. But I’m a nurse, and I’ll be honest with ya, laid up for 6 weeks or not, you better watch your numbers like a hawk. A1c is an average of your glucose levels for the past 3 months, so even if you’ve been laid up for 6 weeks, doesn’t really explain the other 6 weeks before that. Plus, even if a normal non-diabetic person was laid up for 3 months, they would not have numbers even close to yours, so there’s some metabolic disorder goin on. So just monitor things, that’s all. Probably at least get on some metformin.

As far as the high free testosterone, I wouldn’t worry about it. It’s not too too high, and I highly doubt it’s what’s causing your issues. You have a lowish SHBG, I would say the most likely culprit is your elevated E2. It’s not that high for say a guy like me with a higher SHBG, but for you, it’s most likely making you feel like garbage. You probably need to get your E2 closer to 30 to feel optimal I would imagine. I would also switch to injecting EOD if I had your SHBG level. This will help with E2 as well. You could also try lowering your dose a tiny bit, since you clearly have room in the free T department. Either one of those will lower E2. Doing both would obviously be ideal.

Lastly, make sure to get your b12 up. You want that closer to 1000. I try to keep mine at the very least 1000, if it’s a little higher even better. Improving your b12 should definitely help with energy and a ton of other stuff most guys don’t even think of. Here’s an amazing video that will change the whole way someone looks at b12. Its pretty mind blowing. Was for me at least.

And don’t forget about your bottom of the barrel DHEA level. Without that optimized, you’re never gonna feel great. The body works as a whole, we can’t just pick and choose what we want to optimize and expect to feel good. Doesn’t work like that unfortunately. You have to address all deficiencies. They all work synergistically together.
 
Not diabetic. Just came off a surgery and laid Up for 6 weeks. Gained some weight and no gym for me = increased insulin resistance. Was just concerned about the free test being so high
Your elevated fasting serum glucose, insulin, ALT and HgbA1c as indicated in your labs are all consistent with diabetes. Confusingly, your amylase is high, which is usually low in diabetics (unless they are in diabetic ketoacidosis (unlikely) or also have pancreatitis). Did your recent surgery involve your pancreas? In any event, unless they're lab errors or one-offs, those are somewhat concerning metabolic markers. You might want to consider consulting an endocrinologist and/or having an oral glucose tolerance test.
 
Now I feel bad, we’re probably scaring the crap out of this guy lol. But I wouldn’t worry about it too much. Even if you are in a state of pre diabetes, type two diabetes can almost always be remedied. So I’m sure u’ll be able to get all those numbers back on track in no time. Dnfuss has a good point though, you might want to work with an endocrinologist until everything is back to normal.
 
Thanks for all the concern about the diabetes. I’ve been a diabetes rep for a major company for 16 years and do watch my numbers like a hawk. I was also transitioning off a glp-1 and my beta cell response was probably little sluggish not to mention my diet was completely garbage. I did have a concern with the low dhea. It my understanding that dhea can increase e2
 
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Thanks for all the concern about the diabetes. I’ve been a diabetes rep for a major company for 16 years and do watch my numbers like a hawk. I was also transitioning off a glp-1 and my beta cell response was probably little sluggish not to mention my diet was completely garbage. I did have a concern with the low dhea. It my understanding that dhea can increase e2

How ironic is this! Lol. After all this diabetes talk, turns out you’re a diabetes rep?? That’s it, I’m convinced we’re in a simulation now haha. But yes, Dhea can definitely raise E2, but that’s usually only if you take doses that are on the higher end of the scale. Here’s a good video explaining that studies have shown, as well as anecdotal accounts, that men may get the same benefit from DHEA with much much smaller doses, without the side effect of E2 increasing too much.

I believe the studies say that as long as you stay under 15mg per day, that you will avoid most of the side effects. A doctor with a famous forum Ray Peat, for example, takes 5mgs per day, with good results apparently. Even if you end up needing a much higher dose, just start very slow and titrate up if needed. With DHEA, there’s no feedback loop. So it won’t shut off your endogenous production, it only adds to whatever natural production you have going on. So no reason to start with 25mg or anything. I would personally start with 5mg, and titrate up if needed.
 
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